title: Alternate day rosuvastatin, an underutilized option in statin intolerant hyperlipidemic patients: a case report and literature review.
abstract: Statin agents have proven effective in primary and secondary prevention of cardiovascular disease. Approximately 10-15 percent of patients on statin agents discontinue these agents because of myalgia. We report a patient with a remote history of a transient ischemic attack, significant hyperlipidemia and a positive family history of vascular disease and intolerance to multiple lipid lowering agents, including several statin agents. The patient was started on 5 mg rosuvastatin every other day with no adverse symptoms. The dose was increased to 20 mg rosuvastatin every other day over approximately four months resulting in a 39-percent decrease in LDL levels and a 14-percent improvement in HDL levels with excellent tolerability. The long half-life of rosuvastatin along with its high potency make it a good candidate for alternate-day administration. While few studies have evaluated the efficacy of the described alternate-day statin therapy, the failure to address significant hyperlipidemia is associated with adverse health outcomes and costs. Alternate-day statin agent use remains an underutilized option in patients intolerant of daily statin administration. While significant cost benefits also may occur with an alternate-day regimen, prospective studies are needed to confirm the long-term safety and efficacy of this mode of administration.
authors.affiliation: Yakima Regional Medical and Cardiac Center, Yakima, WA, USA.
authors.forename: Bhavya H
authors.initials: BH
authors.lastname: Gopalagowda
authors.forename: Coleman
authors.initials: C
authors.lastname: Cutchins
authors.forename: Della C
authors.initials: DC
authors.lastname: Cutchins
authors.forename: Alan N
authors.initials: AN
authors.lastname: Peiris
mesh_terms: D004334:Drug Administration Schedule; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects*; D006949:Hyperlipidemias / Q000188:drug therapy*; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced / Q000517:prevention & control*; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium